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theEvc�voF � '�ONSTRUCTION -� �- �. <br /> everett PERMIT PERMIT NO. 1OO7H <br /> QTY HALL 259�8745 <br /> EVEREiT.WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br /> O\VNEN MAII AODRE55 GItY � -ZIP PNONE <br /> E. W. Ostlund 1414 Oakes Everett 98201 _ <br /> RRCnI1ECTO0�E5iGNER MRILFOORE55 CrtY ZIP PMONE <br /> GENEPALCANThACiOR MAItADDRE55 CIiY 21P FHONE LICENSE� <br /> MEGHANiCALCANiRACiOP MRILAODRESS CITY ZIP PHONE IICENSE� <br /> Natural Gas Equipment 1611 East Grand Everett 98201 258-2441 <br /> PWMBINGCANiRRLTOP MAILRDORE55 CIiY ZIP FHONE LiCENSEI <br /> CUSS Oi WORK <br /> ❑NEW ❑ADDITION ❑ALTERATIDN ❑REPAIP ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VALUATION OF WOIiN <br /> E <br /> DESGRIBE WOPK <br /> PROPOSED USE OF 9WL�ING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LECJdDESGRIPT10NOFPNOFfRTY�SNOWBEIOWORATTAGNFOUHCOPIES) PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �or BlOC1L_OF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PEPMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TH E PRO- <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> S�GN i E OF fANiRACTOR OR AUTHORRED AGENi �A� <br /> JOB�DDRE55 �. /��J � �� � <br /> 1414 Oakes X ���• <br /> PLUMBINO MECH NICA <br /> NO. TYPE OF FI%TUHE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEq AIR WND.UNITS—H.P.EA. <br /> BATHTUB REFPIGERATIOi+UNITS—H.P.EA <br /> LAVATORV�WASH BASIN� BOILERS—H.P.EA. <br /> SHOWER GAS PIRED A.C.UNITS—10NNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SvSiEMS—flT.U. M EA. <br /> DISHWASHER WALLNEATERS—B.T.U. M <br /> LAUNORY TtiAY UNIT HEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER MEATEH CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR ORAIN AIR FIANDLING UN�T— C.F.M. <br /> VRCUUM BREAKERS STOVE <br /> ROOF DRAINS—PAMLEAOERS METAL FIFEPLACE 8 CHIMNEY <br /> 2 �� <br /> SINK(SERVICE—BAR.ETC.1 <br /> SUB TOTAL SIIB TOTAL S 2 <br /> PERMIT f PERMIT f 00 <br /> lOTAL FEE f TOTAL FEE f <br /> SIDE YARD SeTBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBEfl PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE lOT AREA VACANT SITE <br /> ❑YES ❑NO FEES VALUATION FEE <br /> TYPE OF CANST. OCCUPANCY GROUP N0.OF DWELLING UNITS <br /> BUILDING $ <br /> SIZE OF BLDG. N0.OF STORIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT REOUIRED KLERS MECHANICAL <br /> ❑YES llNO 5 �O <br /> ' APPROVALS BY DATE OTHER <br /> 1. ENVIRONMENTALCNECKLIST pENA�n• U.B.C. <br /> SEC 903�a) <br /> 2. BUILDING PLANS <br /> TOTAL 5 0 0 <br /> 3. FIRE HYDPANi <br /> 4. FIRE PPOTECTION SVSTEM PERMIT YALIDATION <br /> WHEN PROPEPLV VALIUATED(IN THIS SPACE)TNIS IS VOUR PERMIT <br /> 5. GRADING � i ' . � � f n r _� <br /> 6. DRAINAGE � <br /> 7. ENVIRONMENTALIMPACTSTATEMENT � <br /> � 8. HEALTH DISTRICT �. � O <br /> APPUCATION ACC.BY PLANSCHECKED BY APPR.FORISSUANCEBY ; ' �_� <br /> i <br /> ADDRE55 FILE <br />